Intravenous (IV) needles are frequently used in medical procedures. As with any invasive procedure, IV-related infections are a significant concern. Where repeated access to the bloodstream is needed, IV catheters are used. These catheters frequently use cylindrical Luer fittings and valves as an alternative to traditional needle based injection ports. However, in order to be effective, catheters must avoid dislodgment as well as avoid bloodstream infection and local site infection.
IV catheter securement poses a number of challenges. In order to maximize residence time, IV catheters must be secured from dislodgement or causing damage from unwanted movement. The insertion site should also be easily inspected for and protected from contamination or infection. Preferably, the catheter port can also be readily serviced.
Traditional methods call for securing the catheter insertion site with a gauze dressing or a transparent film with adhesive tape. Adhesive tape is problematic in that it is difficult to keep sterile and is prone to irritate a patient's skin. The use of a transparent film is preferable since it serves as a pathogenic barrier and permits viewing of the insertion site. However, transparent films are problematic in that the film eventually loosens from casual contact and permits catheter migration.
The disparity in diameter between an IV needle and a Luer fitting further complicates the securement problem. While an adhesive strip can be taped over the Luer fitting to secure the Luer fitting to the skin, the opaque tape prevents visual inspection of the Luer fitting. Moreover, securing the Luer fitting under a transparent film or under adhesive tape is problematic in that the larger diameter of the Luer fitting acts as a spacer and creates a gap between the film or tape and the patient's skin. This gap defeats the infection barrier purpose of securement.
Another approach is embodied by an IV holder produced by ConMed, Inc., of Utica, N.Y., generally described in U.S. Pat. No. 4,669,458. The ConMed, Inc., device is a catheter dressing with a generally tear-drop shaped frame with a base strip that completely encloses a polymer window. In operation, the polymer window is positioned over the area where the intravenous needle enters the skin and the body of a patient. The transparent cylindrical Luer fitting used to secure the intravenous needle to a tubing assembly itself is adhesively secured taping down the base strip over Luer fitting.
One significant disadvantage of the ConMed dressing is that because the Luer fitting is secured by and under the base strip, it is not readily inspected for blockage. In addition, it is also difficult to disconnect or replace the Luer fitting without removing the entire dressing. Yet another disadvantage is that owing to the comparative larger diameter of the Luer fitting as compared to the intravenous needle and intravenous tubing, securing the Luer fitting with the dressing tends to create gaps between the elevated dressing and the patient's skin. This gap is detrimental to a primary function of the IV holder, i.e. to seal the area around the intravenous needle to prevent fluid and foreign contaminants from entering the patient's body at the insertion site.
There is thus a need for a IV holder to alleviate the disadvantages of those IV holders available in the present art. Specifically, the IV holder of the present invention readily permits access to the Luer fitting and maintains a closer seal around the needle insertion site.